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New Chief Exec Faces Challenge To Ensure CQC Is Fit For Future

A Public Accounts Committee report on CQC has said that action is needed by the regulator on publication of reports, staffing assumptions, intelligence-gathering and more.

In its third report on CQC since 2012, the Public Accounts Committee has found that the Commission has improved significantly over this period, however, it says that there remain areas where CQC needs to improve its current performance, it does not make inspection reports available to the public quickly enough following an inspection and it needs to improve how it interacts with and regulates GP practices.

The Care Quality Commission is the independent regulator of health and adult social care in England. It plays a vital role in ensuring people receive safe, effective, compassionate, high-quality care.

CQC’s workload likely to increase if services deteriorate

It also has a number of challenges ahead. With health and care providers under severe financial pressure, the Commission’s workload is likely to increase if services deteriorate. The Commission needs to monitor this closely and understand the impact on its staff requirements.

The Commission wants to move to a more intelligence-driven regulatory approach, but to do so it must improve its information systems. It also has more work to do to ensure it has the wide range of intelligence it needs to identify early warning signs of poor care.

Since our evidence session, Sir David Behan has announced his retirement. The new Chief Executive will have a big task to ensure the Commission is able to tackle the big challenges that are on the horizon.

Chair’s comments

Comment from Committee Chair, Meg Hillier MP:

“Sir David Behan is stepping down after six years running the Care Quality Commission. The regulator has improved significantly under his stewardship but there is no room for complacency.

Sir David’s successor will inherit a mixture of persistent weaknesses and looming challenges. These must be tackled amid Commission funding cuts and continued financial pressure across the health and care sectors.

Both are a potential threat to the Commission’s ability to carry out its duties, which would in turn undermine the ability of patients and their families to make timely and informed choices about care.

As it stands, the Commission still does not meet the turnaround targets it sets itself for publication of inspection reports. It must do better, particularly on hospital reports, and we expect it to demonstrate progress.

There is also significant work to be done on information-gathering. It is a simple point, but the Commission cannot hope to fulfil its vision of intelligence-driven regulation until it has in place systems that are up to the job.

Even then, it must ensure the information feeding those systems is adequate to flag the early signs of poor care. That means investing time in building relationships at the frontline with Healthwatch groups, CCGs and others.

The recent decline in whistleblower numbers requires investigation; the Commission must act to understand why this has happened and ensure people can feel confident coming forward with what is often critical information.”

Sir David Behan, Chief Executive of the Care Quality Commission, said: “I am delighted that the Public Accounts Committee has recognised the way CQC ‘has improved significantly’ since 2012.

“This is down to the dedication of CQC staff right across the country who work to ensure that people receive the safe, high-quality and compassionate care they deserve and encourage services to improve.

“We acknowledge that there is more to be done and staff are actively working to deliver on the key recommendations, such as decreasing the time taken to publish our hospital inspection reports and the improvement of our digital monitoring systems. In accepting the Committee’s recommendations we do not underestimate the task at hand. But with the commitment of our staff, I am confident that CQC will continue to improve and serve the public well.

“People tell us they experience health and care services that are not personalised to their needs, and that are fractured and fragmented. In the future, in addition to inspecting individual services it is important that CQC is able to continue the work we have already begun in reviewing how local systems are working – whether this is undertaking local systems reviews in the way that services for older people are provided – or in the way that children and young people are supported by mental health services.

“It is essential that the public, professionals and politicians have confidence in CQC and that we continue to make progress. To this end, we will report publicly to the CQC Board and to the Committee on our progress against the recommendations.”

Care England, the largest representative body for independent providers of social care has welcomed the latest report from the Public Accounts Committee concerning the Care Quality Commission (CQC). The report warns that the new Chief Executive of CQC will have many challenges to face, but that much progress has been made.

Professor Martin Green OBE, Chief Executive of Care England says:

“From an adult social care perspective, the key points in the Public Accounts Committee’s report are that the system reviews are helpful. The Government needs to now show what plans it has for the oversight of the health and social care system and in turn draw lessons from the reviews”.

The report flags up that CQC’s workload will increase if services deteriorate; it is important that CQC ensures that it has the staff in place to deal with such consequences and currently 20% of re – inspections are in response to receiving information of concern by the public or others. Another important recommendation is that inspection reports need to be produced quicker; people value fast turn arounds and certainty.

Professor Martin Green continues:

“The report, although encouraging, does demonstrate the need for better use of intelligence as an early warning system of provider quality failure especially working with local Health Watch and CCGs. In conjunction with this it is important that CQC makes sure that digital and information collection is in place and functioning smoothly”.

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